Browsing by Author "Lohani, B"
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Publication Accuracy of ultrasonography in evaluation of level and cause of biliary obstruction: a prospective study(Kathmandu University, 2005) Ghimire, R; Lohani, B; Pradhan, SAim: To find out the accuracy of ultrasound in evaluation of level and cause of biliary obstruction. Materials and methods: Forty-five patients (26 to 86 years of age) with suspected biliary obstruction underwent Ultrasonography followed by Direct Cholangiograms (Percutaneous Transhepatic Cholangiography / Endoscopic Retrograde Cholangiography). The levels of biliary obstructions were grouped as hilar, suprapancreatic and intrapancreatic. Similarly the causes were grouped as malignant and benign. Diagnosis was confirmed either at surgery or histopathologically (USG-guided FNAC or ERC-biopsy). Results: Ultrasonography accurately identified the level of obstruction in 89 %( hilar), 91 %( suprapancreatic) and 87 %( intrapancreatic) cases. Malignancy was found in 33 patients and remaining 12 had benign diseases. USG accurately identified malignant and benign causes in 91% and 84% cases respectively. Findings were found to be statistically significant (p-value=<0.05 at 95%confidence interval). Conclusion: This study showed that USG has high accuracy in identifying the level and cause of biliary obstruction. Considering cost, availability and patient friendly nature, Ultrasound should be the first imaging modality of choice in evaluation of biliary obstruction. Key words: Ultrasound, biliary obstruction, direct cholangiogramPublication Predictive value of ultrasonography in the diagnosis of palpable breast lump(Kathmandu University, 2003) Pande, AR; Lohani, B; Sayami, P; Pradhan, SA lump is the first symptom in over 80 percent of all patients with cancer of the breast. Consequently, the finding of any lump in the breast is a highly significant sign and warrants a thorough investigation. The present study was undertaken to study the predictive value of ultrasonography in the diagnosis of palpable breast lumps. Fifty-two female patients with palpable breast lumps that were unilateral underwent ultrasonography of the breast. Thirty-six of these patients who had solitary, unilateral, solid lumps were followed up with FNAC/biopsy/mammography and the findings were compared. The mean age group was seen to be 41 years. The youngest patient was 17 years old and the oldest was 80 years. The validity of USG in the diagnosis of palpable breast lumps was calculated. A sensitivity value of 95%, specificity of 94.10%, positive and negative predictive values of 95.50% and 93.75% were noted and were comparable to other similar studies. The sensitivity, specificity, positive and negative predictive values were statistically significant (p=0.0000006) and were comparable to the values obtained by different studies conducted elsewhere. Among the multiple USG parameters, shape, margins, vascularity, surrounding tissue character, sound transmission through the lump were more significant in the diagnosis of benign vs. malignant lumps. Echogenicity and echotexture were of less significance. Key words: Breast lump, Ultrasound, FNACPublication Real Time Trans-Rectal Elastography of Prostate Correlation with Histopathology in a Suspected Case of Prostate Cancer(Kathmandu University, 2021) Basnet, B; Suwal, S; Chataut, D; Lohani, B; Paudel, SABSTRACT Background Early detection of prostate cancer, the second most common cancer in men worldwide, is the key for its successful treatment. Commonly used clinical criteria and imaging tools for detection of prostate cancer are less sensitive. Objective This study was aimed to find role of real time transrectal elastography of prostate for detection of prostate cancer. Method Study was conducted in 66 patients with clinical suspicion of prostate cancer, who were sent for ultrasound guided prostate biopsy. Transrectal ultrasound with real time elastography was performed in all the patients prior to the biopsy and looked for hard areas within the prostate. Then six-core tru-cut biopsy were taken in six zones of prostate, including the hard areas detected in the elastography. The histopathology report were correlated with the elastography findings. Result Median prostate specific antigen of the patients was 11.5 ng/ml with interquartile range of 8 to 23.5 ng/ml. Digital rectal examination showed hard nodular findings in 35 patients. Transrectal ultrasound showed 81 hypoechoic lesions in 31 patients. Elastography showed 127 hard areas in 31 patients. Histopathology showed 90 positive biopsy cores in 23 patients. Cancer detection rate of elastography was 82.6%. At 95% confidence interval, patients with elastography detected hard lesions had 19.4 times more likelihood to have prostate cancer. Sensitivity of elastography was high as compared to digital rectal examination and transrectal ultrasound alone. Conclusion Transrectal elastography had high sensitivity over clinical tools and transrectal ultrasonography for detection of prostate cancer. KEY WORDS Biopsy, Prostate cancer, Transrectal elastography